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Drain After Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis. A Pilot Randomized Study

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Abstract

Drainage after laparoscopic cholecystectomy (LC) for acute calculous cholecystitis (ACC) is used without evidence of its efficacy. The present pilot study was designed to address this issue. After laparoscopic gallbladder removal, 15 patients were randomized to have a drain positioned in the subhepatic space (group A) and 15 patients to have a sham drain (group B). The primary outcome measure was the presence of subhepatic fluid collection at abdominal ultrasonography, performed 24 h after surgery. Secondary outcome measures included postoperative abdominal and shoulder tip pain, use of analgesics, and morbidity. Abdominal ultrasonography did not show any subhepatic fluid collection in eight patients (53.3 %) in group A and in five patients (33.3 %) in group B (P = 0.462). If present, median (range) subhepatic collection was 50 mL (20–100 mL) in group A and 80 mL (30–120 mL) in group B (P = 0.573). No significant differences in the severity of abdominal and shoulder pain and use of parenteral ketorolac were found in either group. Two biliary leaks and one subhepatic fluid collection occurred postoperatively. The present study was unable to prove that the drain was useful in LC for ACC, performed in a selected group of patients.

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References

  1. Strasberg SM (2008) Clinical practice. Acute calculous cholecystitis. N Engl J Med 358:2804–2811

    Article  PubMed  CAS  Google Scholar 

  2. Gurusamy KS, Samraj K, Mullerat P, Davidson BR (2007) Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy (review). Cochrane Database Syst Rev 4:CD006004

    PubMed  Google Scholar 

  3. Tzovaras G, Liakou P, Fafoulakis F, Baloyiannis I, Zacharoulis D, Hatzitheofilou C (2009) Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg 197:759–763

    Article  PubMed  Google Scholar 

  4. Picchio M, De Angelis F, Zazza S, Di Filippo A, Mancini R, Pattaro G, Stipa F, Adisa AO, Marino G, Spaziani E (2012) Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial. Surg Endosc. doi:10.1007/s00464-012-2252

  5. Navez B, Ungureanu F, Michiels M, Claeys D, Muysoms F, Hubert C, Vanderveken M, Detry O, Detroz B, Closset J, Devos B, Kint M, Navez J, Zech F, Gigot JF, The Belgian Group for Endoscopic Surgery (BGES) and the Hepatobiliary and Pancreatic Section (HBPS) of the Royal Belgian Society of Surgery (2012) Surgical management of acute cholecystitis: results of a 2-year prospective multicenter survey in Belgium. Surg Endosc. doi:10.1007/s00464-012-2206-2207

  6. Takada T, Kawarada Y, Nimura Y, Yoshida M, Mayumi T, Sekimoto M, Miura F, Wada K, Hirota M, Yamashita Y, Nagino M, Tsuyuguchi T, Tanaka A, Kimura Y, Yasuda H, Hirata K, Pitt HA, Strasberg SM, Gadacz TR, Bornman PC, Gouma DJ, Belli G, Liau KH (2007) Tokyo guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Surg 14:1–10

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mayumi T, Takada T, Kawarada Y, Nimura Y, Yoshida M, Sekimoto M, Miura F, Wada K, Hirota M, Yamashita Y, Nagino M, Tsuyuguchi T, Tanaka A, Gomi H, Pitt HA (2007) Results of the Tokyo Consensus Meeting Tokyo Guidelines. J Hepatobiliary Pancreat Surg 14:114–121

    Article  PubMed  PubMed Central  Google Scholar 

  8. Huskisson EC (1974) Measurement of pain. Lancet 2:1127

    Article  PubMed  CAS  Google Scholar 

  9. Borzellino G, Sauerland S, Minicozzi AM, Verlato G, Di Pietrantonj C, de Manzoni G, Cordiano C (2008) Laparoscopic cholecystectomy for severe acute cholecystitis. A meta-analysis of results. Surg Endosc 22:8–15

    Article  PubMed  Google Scholar 

  10. Zaydfudim V, Russell RT, Feurer ID, Wright JK, Pinson CW (2009) Drain use after open cholecystectomy: is there a justification? Langenbecks Arch Surg 394:1011–1017

    Article  PubMed  Google Scholar 

  11. Agrama HM, Blackwood JM, Brown CS, Machiedo GW, Rush BF (1976) Functional longevity of intraperitoneal drains: an experimental evaluation. Am J Surg 132:418–421

    Article  PubMed  CAS  Google Scholar 

  12. Garber S, Korman J, Cosgrove J, Cohen J (1997) Early laparoscopic cholecystectomy for acute cholecystitis. Surg Endosc 11:347–350

    Article  PubMed  CAS  Google Scholar 

  13. Unger W, Glick G, Landeros M (1996) Cystic duct leak after laparoscopic cholecystectomy: a multi-institutional study. Surg Endosc 10:1189–1193

    Article  Google Scholar 

  14. Monson RTJ, Keane BVF, Brenman GT (1991) Cholecystectomy is safer without drainage: the results of a prospective, randomized clinical trial. Surgery 109:740–746

    PubMed  CAS  Google Scholar 

  15. Farha JG, Chang CF, Mathews HE (1981) Drainage in elective cholecystectomy. Am J Surg 142:678–680

    Article  PubMed  CAS  Google Scholar 

  16. Budd CD, Cochran CR, Fouty JW (1982) Cholecystectomy with and without drainage. Am J Surg 143:307–309

    Article  PubMed  CAS  Google Scholar 

  17. Dougherty SH, Simmons RL (1992) The biology and practice of surgical drains. Part II. Curr Probl Surg 29:633–730

    PubMed  CAS  Google Scholar 

  18. Neri V, Fersini A, Ambrosi A, Tartaglia N, Valentino TP (2008) Umbilical port-site complications in laparoscopic cholecystectomy: role of topical antibiotic therapy. JSLS 12:126–132

    PubMed  PubMed Central  Google Scholar 

  19. Hawasli A, Brown E (1994) The effect of drains in laparoscopic cholecystectomy. J Laparoendosc Surg 4:393–398

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Marcello Picchio.

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Lucarelli, P., Picchio, M., Martellucci, J. et al. Drain After Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis. A Pilot Randomized Study. Indian J Surg 77 (Suppl 2), 288–292 (2015). https://doi.org/10.1007/s12262-012-0797-9

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  • DOI: https://doi.org/10.1007/s12262-012-0797-9

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